how do i come off lexapro

Resolved Question:

First of all, you need to tell your doctor about this as soon as possible and then discuss with him or her about tapering it down.

Dr Vikas :

Lexapro need to be taper down slowly to avoid discontinuation / withdrawal symptoms as you must be knowing.

Dr Vikas :

Most patients are able to taper it down by reducing 5 mg per 4 to 5 days or may be 10 mg per 4-5 days depending on the toleribility.

Dr Vikas :

For example, if a patient is taking 10 mg per day, he or she can start tapering by taking 5 mg for 4 to 5 days and then discontinuation.

Customer:

My doctor said the other day that it is not a true anti-depressant that it is not meant to make you feel happy like other anti-depressants is that true? I feel numb all the time, disconnected, not in my body, so far away from from everything and he said that is the whole point of it. I hate that. I have no emotion. I can't connect with anything or feel any emotion. He said the whole point of it is so I so don;t get upset with situations etc. All I am doing is existing and I hate it.

Dr Vikas :

I slightly disagree with your doctor here as it is an antidepressant just like all other available in the market.

Dr Vikas :

what is the dose you are currently taking?

Dr Vikas :

are you there?

Customer:

yes I am here

Customer:

I am on 20 mg

Dr Vikas :

some patients who are taking SSRI antidepressant like Lexapro may complain of emotional numbness. You started noticing it after starting Lexapro or it was already there before you started this medicine?

Customer:

I would have with periods coupled with high anxiety

Customer:

now I am numb all the time

Customer:

so it has been good for that

Customer:

now I am a zombie

Dr Vikas :

OK, you need not to worry about this a bit as the situation will improve very soon. Do you think that Lexapro is helping with your anxiety and depressive symptoms or not?

Customer:

I hate because I am not really phased when say bad things happen in the world, it is not as though I don't care

Customer:

I been on it for about two and half years now

Dr Vikas :

and it is helping a bit or not?

Customer:

my anxiety denfinetly

Customer:

my depression--i am flat all the time

Dr Vikas :

OK good, then there are two possible alternative in your case which can be very helpful in controlling this emotional numbness.

Customer:

but i do get a lot of suicidal thoughts

Dr Vikas :

your doctor knows about it?

Customer:

that get quite disturbing and i have to push them out of my mind

Customer:

yes

Customer:

i have tried four times on lexapro

Dr Vikas :

OK, see, you just discuss with your doctor about adding Bupropion (Wellbutrin) along with Lexapro.

Dr Vikas :

have you tried it already?

Customer:

i don't think we have this in my country because i already asked

Customer:

that was in 2010

Dr Vikas :

I don't think so,let me check

Customer:

that i asked, i think you can only get it in the states and a few other countries

Dr Vikas :

http://www.pbs.gov.au/medicine/item/8465M-8710K

Dr Vikas :

check this link

Customer:

australia?

Customer:

has it?

Dr Vikas :

have you gone through the link

Customer:

okay i will

Dr Vikas :

just click it now

Customer:

checking

Dr Vikas :

to check

Dr Vikas :

OK

Customer:

oh wow

Customer:

yes you can get it

Customer:

i will have to talk to him

Dr Vikas :

OK, so you can discuss with your doctor about it and the combination of Lexapro with Bupropion can be very useful in your case in my view

Dr Vikas :

the other thing which you can do right now is to try Cognitive Behavior Therapy

Dr Vikas :

have you tried CBT?

Customer:

i discussed changing and combinations but he was hesitant--the only one he was think was the new form of effexfor

Dr Vikas :

OK, he must be talking about Pristiq (Desvenlafaxine)

Customer:

i started if but the therapist wasn't that great because my home-town we have a lot of psychologists etc--but not a lot that are experienced in cbt so willing to do it but with someone that can actually do it so will have to travel a little bit further. As if I am going to do it I rather do it with someone that has the proper training. I go to a psychiatrist but I don't think he has the time to do cbt (he isn't in my home town anyway)

Dr Vikas :

You now have the option of trying CBT for free online from your home.

Dr Vikas :

would you like to try that

Customer:

I was put on effexor when I was 15 and had a horrible experience so I rather not try it---thanks for the info about well

i was always just give the diagnoses of chronic fatigue and they think maybe my depression will get better when i able work my dosages better

Customer:

we are very strict here on prescribing it so i was a bit confused that it all

Dr Vikas :

you can always discuss with your doctor about it.

Customer:

i know i had to jump through a lot of hoops--mlst's etc

Customer:

i got it though--for cheap

Customer:

people can still get it off label if they have a good enough reason just pay a fortune

Dr Vikas :

Oh

Customer:

just unforunately people will abuse it so they have to be tight about it

Dr Vikas :

can understand.

Customer:

which is sad because it prob help people with depression

Dr Vikas :

it can in certain cases.

Customer:

uni students, shift workers abuse it

Dr Vikas :

it does has some potential for abuse but unusual in clinical practice.

Customer:

it just keeps me awake it really doesn't change my mood but i guess i am able to do more things is that normal?

Dr Vikas :

well, what is the dose you are taking?

Dr Vikas :

The dose range is from 200-800 mg per day.

Dr Vikas :

for problem concentrating and fatigue, dose range of 50-200 mg per day is usually sufficient.

Dr Vikas :

but can be increased further depending on the clinical condition.

Customer:

i know a few american girls who came here on exchange-uni students can't get ritalin like they can in the states--you only get ritalin if you see a doctor that has prescribing rights and you have a diagnosis of add. So they try other things like modafinil. I keep mine at the pharmacy because if I loose it I will not get another one for six months. That is how strict they are.

Customer:

we get funded for 400mg

Dr Vikas :

OK

Customer:

after that we pay for off label

Dr Vikas :

any how, I guess we are drifting from our topic :)

Customer:

my doctor says i should be sitting around the 300mg and wouldn't be concerned if I take 400mg

Customer:

I do believe that it has stirred some of my seizures so i try to manage on 200mg but it is hard

Customer:

is there a link between modafinil and lower seizure threshold

Dr Vikas :

50 -200 mg per day is sufficient in my view.

Dr Vikas :

I don,t think so.

Customer:

basically its the groggy/drunk tiredness that gets me

Customer:

if i can get myself out of that i am okay

Dr Vikas :

You are taking Lexapro in morning or at night?

Customer:

if i am sleep deprived, i don't take much of the modafinil

Customer:

night

Dr Vikas :

then your tiredness is probably because of depression and should respond to CBT and or adding another medicine.

Dr Vikas :

or shifting to SNRI antidepressant.

Customer:

well since i have been on modafinil i i haven't been in situations where i suddenly i just fall alseep

Dr Vikas :

good

Dr Vikas :

:)

Customer:

my neck used to be a slinky

Customer:

where it is was all just floppy and i been sitting there and just fall off to sleep and now I can keep my eyes wide open. I know it sounds dumb but sometimes when i was talking to people it was though i had these heavy weight on my eyelids and they were dragging them down and i was just dopey all the time and my legs were jelly.

Dr Vikas :

it is characteristic of Narcolepsy.

Customer:

i don't feel as dumb

Dr Vikas :

you are responding to Modafinil which is a good thing. Now you just have to start CBT and discuss with your doctor about either adding an antidepressant or shifting you on a SNRI antidepressant.

Dr Vikas :

and hopefully everything will be alright once again.

Customer:

but i still have a few crazy dreams

Customer:

but not as bad

Customer:

well thank you for your help

Customer:

i will do the online stuff

Customer:

everything looks so much better

Dr Vikas :

you are most welcome.

Dr Vikas :

Thanks for coming to JA.

Customer:

no problems

Dr Vikas :

I wish you a very early and speedy recovery. :)

Customer:

thank you

Dr Vikas :

I really enjoyed working with you – please feel free to request me again when you come back to ask another question

Customer:

yes i will

Dr Vikas :

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I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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